I’m up at Spot-on taking explaining very basic economics to the unwashed masses in a piece called Back To School, Business Week and no I didn’t get to choose the title. The main point is that health care is not infrastructure nor is it manufacturing. It’s a service industry, like teaching English Lit.  Come back here to comment.

There’s been a lot of fuss in the last week about the BusinessWeek article that suggested that all employment growth in America in the last year had come in the health care sector.
Well that’s not too surprising. The money pouring into health care has
been going up at more than 10% a year since 2000 while the rest of the
economy has been relatively stagnant (at least compared to
historical growth rates). The non-employment sector of the economy
(i.e. corporate profits) has been growing much faster than the labor
sector. Health care, though, is a labor intensive business – you need
those nurses, techs, and even doctors to look after patients. Continue …

Arnold Kling responds to Moulitas’ (DailyKos) overture to the Libertarians in a piece called Dear Libertarian Democrats… The only slight flaw in all this is that there aren’t very many libertarians, but then again we don’t need too many Republican voters to change sides!

Kling proposes running school choice in a few states and single payer health care in a few states. The only flaw here is in thinking that they’re much different. After all single payer health care in the usual American sense means putting all the money in one social insurance pool and allowing people to choose which doctors and hospitals they go to. As far as I can see school choice in Kling’s version is the same: creating one pool of all K-12 education dollars and letting kids/parents choose the schools they want to go to. In both cases everyone needs to be in the same pool, and the money follows the choice of the individual. I don’t understand how the libertarians can decry one as evil socialism while being OK with the other, unless they really favor repealing universal compulsory education. But maybe they do!

As for the health experiment, it probably depends where they run single payer. But the likelihood is that a really effective single payer plan run across state lines would be a wash. It would attract old school industry (autos) who would get rid of their “obligations” on the state, but it would also attract entrepreneurs suffering from job lock. It might lose jobs from employers with younger than average workforce, but theoretically it’ll be a wash. While single payer may not be the best option for financing health care delivery, and while a universal voucher scheme like educational choice may work too, a compulsory universal single insurance pool is by far the best option.

There are sometimes when two contradictory thought streams start charging through my brain and I can’t cope. This is one.

I got an email from a PR person for this website http://www.yourcandidatesyourhealth.org/ which tells you your local candidates record essentially for or against embryonic stem cell research. As you might guess, the idea from Research!America and the Lasker Foundation is to encourage people to vote against candidates opposing stem cell research (or at least get them to change their mind. The Research!America folks are a cross-section of business and academic types who like medical research.

And honestly how can any rational person be against them? When the choice is between them and the creationists who were only happy when we all lived in the dark ages, and don’t believe in the Enlightenment, personal liberty, the scientific method, et al. (Not of course that they won’t use the technological fruits of the movements they despise, particularly Talk Radio!).

But on the other hand, any really rational assessment of the health care system shows that we are spending way too much on medical research. The NIH alone is $30 billion a year, and that’s about doubled by private industry. Now we’re adding billions more at the state level. The problem is that the application of the products of that research is downright shoddy, and we’re spending almost nothing comparatively to figure out how to make it better.

It would be much better for the country and the health care system if we took the $30 billion spent on the NIH and the $300 million spent on AHRQ and flipped them. Then we’d really figure out how to apply the stuff we already know evenly and appropriately. We just don’t need more me-too cancer drugs at $4,000 a pop, when we can’t figure out how to get an Rx for aspirin in to the hands of discharged cardiac care patients (or whatever the appropriate cheap therapy is).

I’m convinced that if we put a ten year moratorium on all new medical research today, and spent all the money figuring out how to apply—and then actually applying—our medical knowledge across the board, we’d be much better off. Of course that’s never going to happen, and we need to save science from the hands of the anti-Enlightenment Philistines. But I remain to be convinced that the Research!America folks are applying their scientific resources in the most appropriate way possible.

Meanwhile, Steve Parker tells me about the launch of a new site called www.BreastCancerAwareness.com  which is pretty self-explanatory and looks like it’ll be a useful resource.